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March 23, 2011

All material on this blog is provided for information purposes only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, Readers should consult appropriate health professionals on any matter relating to their health and well-being.

The medical information and opinions expressed here are believed to be accurate, based on the best judgement available to the author, and readers who fail to consult with appropriate health authorities assume their own risk of injuries & consequence. This content is intended for entertainment purposes only. LRBF March 23, 2011

REVISITING THE DEFINITION OF LCIS

(LOBULAR CARCINOMA INSITU)

"Abnormal cells within the lobule that don't form lumps. They can serve as a marker of future cancer risk."

(from Dr. Susan Love's Breast Book by Dr. Susan M. Love, 5th edition)

Lobular: Lobules produce the milk

Carcinoma: Cancer that begins in the skin or other tissue that cover or line an internal organ

In-situ: In its original place

SUMMARY: THIRTEEN YEARS AGO

Biopsy No. 1

Under a general anesthetic, they found LCIS

Biopsy No. 2

Under a general anesthetic, LCIS was found again

Biopsy No. 3

Under a general anesthetic. They found 2 lymph nodes which had fused together (benign) but I contracted a STAPH infection that required an emergency hospitalization and home care.

LET’S CONSIDER...

As one might imagine, by this time I was ready to explore the option of breast reduction in an attempt to reduce my risk of developing breast cancer. After the third biopsy in such a short time period, the emotional stress and physical toll brought me to a point where I needed to consider what else I could do to be pro-active. I needed more control.

I referred to Dr. Susan Love’s Breast Book (1992) by Dr. Susan Love to refresh my memory on the section that talked about her female patients who, after enduring several biopsies and all the anxiety that goes with it, were opting for mastectomies - they said the decision for mastectomy was made because it was the not knowing when a lump would show up screaming, “This is it. You’ve got cancer!”

But I wasn’t ready for that drastic step. I didn’t have cancer and the experts were sure that LCIS was only a high risk marker for developing breast cancer in either breast. So other than simply waiting for test results, breast reduction felt like my only pro-active option. After interviewing 3 local breast surgeons I decided to wait. Neither the timing nor the surgeons ‘felt’ right.

THE NEXT TEN YEARS

The next decade I continued to endure annual mammograms and the ocassional ultra sound for back up. Each time I would breath a sigh of relief with the unremarkable results. I remained apprehensive but positive for the first few years and eventually I even fell into a kind of complacency.

WHAT WAS THAT?

Then about 3 years ago I felt something significant. Not a lump or anything like that. I find it hard to find the words to describe it but it was almost a physical ‘nudge’ in my left side - like someone softly jabbing you in the ribs when they want you to see or hear something. And there was a message with the ‘nudge.’ Although I heard it, it was more like my inner voice speaking. No kidding. It wasn’t the first time this had happened during a significant time in my life, so I paid attention.

Whatever this was, it came out of nowhere along with this sense of ‘knowing’ that it was time to revisit the breast reduction option. I did not hesitate or second guess it. My first step was to find a breast surgeon. I did some research on the internet and then went to my GP for the referral. My initial sense that a reduction of tissue would reduce my risk was now reinforced by the ‘nudge.’ I arranged for an appointment to see a highly regarded, breast surgeon.

I LOVE THIS GUY!

He was impressive. He was definitely the one for me. He listened intently to me tell the story of my history with LCIS and my explanation of why I was there. He examined me briefly and then gently explained that he typically only performed mastectomies and then only when cancer is involved. He suggested I see a plastic surgeon for a breast reduction. I was disappointed but thanked him for his time. On my way out of his office, I turned to shake his hand and jokingly remarked that if I ever had to face that situation, he would be my man. He laughed and returned my hand shake warmly. He just had this lightness and loveliness about him.

I had my doctor arrange for the referral to a recommended plastic surgeon I had researched. I never second guessed my decision. I’m not sure the plastic surgeon completely understood my reasoning, but he definitely was on board to reduce my breasts for other health benefits. While my breasts weren’t huge, they were certainly ‘heavy’ and had managed to take a toll on my back and neck over the years, so the relief of this surgery would be twofold for me.

WHAT IS WITH MY VEINS?

By early June, I was booked into the hospital for my breast reduction and went through the usual pre-op testing. Finally the day arrived and I was required to be at the hospital by dawn. Of course they had difficulty finding a vein to accomodate the pre-op IV. Two nurses tried and when they invited a third one to have a go, I put my foot down. Enough was enough.

“No more.” I said firmly. They called the OR to advise I’d be arriving with an empty arm. The anethesiologist was clearly not pleased with this delay. He also advised that I would be given morphine for pain. I’d never had morphine before so I didn’t know if this was a good thing or not. The last time I’d had surgery they’d been using Demerol, which I had no problem with. No nausea, no reaction, no pain.

The operation was uneventful and I woke up in recovery, after which I was moved to a room with 3 other recovering patients. I was kept overnight and released the next morning with only one incident worth repeating here. Shortly after settling into the room, I began throwing up - reaction to morphine? The bed covers and I were quickly covered in vomit. Terry pushed the intercom button and told them we needed a nurse right away. Apparently this statement was open to interpretation.

‘NURSE RATCHED’ I PRESUME?

When the nurse eventually arrived, she eyed me warily from the doorway and said, “Oooh, I’ll be back and clean it up later.” To which I adamantly replied, “No way! Clean this up now and help me to the washroom. I’m not lying in vomit.” She sighed but did as I asked. I threw up once more while in the washroom and was reluctantly helped into a clean gown by 'Nurse Ratched.' Once back in bed, I apparently crashed because when I next opened my eyes, I was in complete darkness and no Terry by my bedside. I didn't know what time it was. I was hungry and thirsty, and still attached to the IV pole, so I laid there waiting. I buzzed the nurses station and was told that he'd been advised that I'd likely be out for the night, so he should come back early in the morning to check me out. He watched me drooling onto my pillow for a while longer before heading for home, under the assumption I'd be well looked after. HAH!

NEEDING MORE THAN JUST AN ADVOCATE

As it turned out, I really did need him as it was a horrible feeling to wake up alone like that - needing someone to do the little things for you, like making sure you have ice water within reach or helping you maneouvre the IV pole while you struggle to maneuver in the narrow washroom - but mostly just to have someone there for comfort when you open your eyes. He couldn't have anticipated my reaction of course and felt terrible when he arrived the next morning to find out I’d felt completely abandoned. He was determined to make up for it though, and while I pouted mightily, he made a point of finding a Starbucks so I could have my coveted, double-shot, soy latte to sip on the long drive home. Sweet boy..

NOW I CAN FINALLY RELAX!

I had made the mandatory appointment to have the stitches removed in a week and continued to heal and recover without incident. My breasts were still swollen but you could see that they were definitely smaller. I was pleased. I felt safe. I'd done the right thing.

NOT SO FAST...

This brings us full circle to the day I got the phone call from the plastic surgeon regarding the pathologists report on my breast tissue. (Part 1 of 5 LCIS)

I was in the garage painting - getting more paint on me than the project, when I heard the phone ring inside the house. I decided to let it go to message, intending to retrieve it later. The garage door was wide open and I was enjoying the warm breezes wafting around my face as I tidied up.

Standing in my kitchen, I was listening to the missed message. It was my surgeon and he seemed to be choking on his words. He had just read the pathologists report he continued... “I’ve been a surgeon a long time. This pathologist is even older than I am and he told me that he's never seen anything like this. I need you to call my office right away. I have to catch a flight shortly and I hate to leave this message without talking to you. I'm sorry. Please, call the office right away and get my instructions. I’m so sorry I'm unable to talk with you about this (long pause and a sigh). Please call right away.”

This was Friday. I called his office but he’d already left for the airport by then. However, he’d booked an appointment for Monday with a breast surgeon and I was told that it was considered an urgent matter so could I please arrange to be there. I grabbed a pen to write down the name and address of the doctor I was to see on Monday. “Sorry, who did you say I’m to see?” She repeated the name. I smiled..

THE UNIVERSE IS LINING THINGS UP...

It was the surgeon I had liked so well. The one I told hewould ‘be my man’ if I was ever in the position of needing a mastectomy. In spite of the alarming news I’d just received, I knew this was a good sign - I believed things were lining up for a reason.